How much rates vary
Facilitymedian $339 · 10th to 90th $83 to $692Professionalmedian $155 · 10th to 90th $85 to $309
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $154.88 | Facility | None | $83.18 | $83.18 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $147.91 Typical High $269.15 | Professional | None | $83.18 | $147.91 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $162.18 Typical High $309.03 | Professional | None | $95.50 | $162.18 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $691.83 Typical High $707.95 | Facility | None | $56.23 | $691.83 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $213.80 Typical High $323.59 | Professional | None | $123.03 | $213.80 | $323.59 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $109.65 Median $190.55 Typical High $316.23 | Professional | None | $109.65 | $190.55 | $316.23 |
Martin's Point Setting Professional Modifier None Typical Low $83.18 Median $154.88 Typical High $269.15 | Professional | None | $83.18 | $154.88 | $269.15 |
United Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
United Setting Professional Modifier None Typical Low $123.03 Median $190.55 Typical High $295.12 | Professional | None | $123.03 | $190.55 | $295.12 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $41.69 Typical High $75.86 | Professional | 52 · Reduced service | $41.69 | $41.69 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $30.90 | Professional | 53 · Discontinued | $16.60 | $16.60 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $63.10 Typical High $114.82 | Professional | 54 · Surgery only | $63.10 | $63.10 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $22.91 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $15.49 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $58.88 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $58.88 | $58.88 | $107.15 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $41.69 Typical High $75.86 | Professional | 52 · Reduced service | $41.69 | $41.69 | $75.86 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $30.90 | Professional | 53 · Discontinued | $16.60 | $16.60 | $30.90 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $63.10 Typical High $114.82 | Professional | 54 · Surgery only | $63.10 | $63.10 | $114.82 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $22.91 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $22.91 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $15.49 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $15.49 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $58.88 Median $58.88 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $58.88 | $58.88 | $107.15 |
Where Maine sits
The same service costs 4.5 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Maine· 26th of 51
$155
AK $407KY $91.20
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.